### IN THE COURT OF APP EALS OF TENNESS EE AT NAS HVILLE N ove m be r 18, 200 5 S es sio n

TERES A A. CAR PENTER v . TIMO THY P. KLE PPER, ET AL


### .
Appeal f romthe Circ uit Court for Montgom ery C ounty No. 50200519 Ross H. Hicks, Ju dge

No. M2004- 02951-COA-R 3-CV - F iled March 16, 2006

P l ai n t i ff fi l ed a medical malpra ctice a ction ag ainst doctor and his e mploy er. The jury returne d a verdic t in favor of Defenda nts. Plaintiff appea led the admission into evidence of expert testimony offe red by

two phy sicians under

the locality

rule and the awa

rd of c erta in discretionary costs. The judgme nt of the trial court is rever sed and the case rema nded for a new trial.

Tenn. R. App . P . 3 Appeal as of Right; Judgme nt of th e Circ uit Court Reve rsed

W I L L I AM B. C A IN , J
., delivere d the opinion of the court, in w hich P ATR I C I A J. C O T T RE LL and F R ANK G. C L EME NT , J R ., J J ., joined.

R. St ephen Do u gh t y and Alvin L . Har ris, Nashville, Tenne ssee, f or the a ppellant, Ter esa A

. Carpente r.

Rob e rt A. Ta lle y and Den ni s P. Ha wk ins , M e mph is, Te nn e sse e , f or the app e lle e , T imo thy

P. Klepper

.

W. Sc ott Sims , N a sh vil le , T e nn e sse e , f or the app e lle e , Pr e mie r M e dic a l G ro up , P. C.

OP IN ION

On Aug ust 8, 2 0 02, Tere sa A. Car penter (Carpe nter) f

iled a medica l malprac tice ac tion

a g a ins t T imo thy

P. Kl e pp e r, M. D. (K le pp e r) a nd Kl e pp e r’ s e mpl oy e r, Pr e mie r Me dic a l Gr ou p, P.C. (Premier ), alleg ing tha t Klepper neg lige ntly perf ormed laparoscopic surg ical repair of her umbilical hernia during outpatient surg ery in Clarksville, Montgomer y County , Tenne ssee on Nove mber 2, 2001.

A jury

trial of the a ction beg an on Aug ust 2, 2004. During the course of the trial, Kleppe r

c a lle d e xpe rt

wi tne ss, Willi a m S. Aa

ro n, M. D. (D r. Aa

ro n) a nd Pr e mie r c a lle d e xpe rt wi tne ss, Er ic J . DeMa ria, M.D. ( Dr. De Maria) to testify as to the applica

ble standar d of ca

re a nd whether

Dr.2

Kl e pp e r de viate d be low that sta nd ard in his c are of Carp e nte r. Af te r voi r dir e e xami na tio n o f b oth experts, Carpenter

objected tha t Drs. Aar on and De Maria f ailed t o m eet the r equire ments of Tenne ssee Code A nnotated, sec tion 29-26-115, otherwise known as the locality rule. The trial court

o v e rr u l e d C arp e n t e r ’ s o b

j e c t i o n s a n d a l l o w e d D r s

. A ar o n a n d D e M ar i a t o t e s t i f y.
On Aug ust 6, 2004, the jury returne d a ver dict in favor of De fe n d an t s , finding that Dr. Klepper did not deviate below the applicable standard of car e. On August 25, 2004, the trial court enter ed a judg ment in favor of Def endants in ac corda nce with the jury verdic t. On September 24, 20 04 , Ca rp e nte r file d a mot ion fo r a ne w t ri a l, a sse rt ing that th e tr ia l c ou rt e rr e d in a llo wi ng Dr s. Aar on an d De M aria to testify as expert witnesses for

Def endants be cause neither e x pert met the require ments of the loca lityrule. On N ovember 12, 2004, the t rial court entere d an orde r deny ing Carp e nte r’ s mo tio n f

or a ne w t ri a l.

On September

24, 2004, Premier filed a mot ion seeking discretionary costs of $19,927.46, howeve r, counse l for Premier filed an affida vit on November 4, 2004, r educing the amount soug ht by $4,750.00. On Octobe r 4, 2004, Dr. K lepper filed his ow n motion for $16,930.48 in discretionary

c os ts. Carp e nte r f

ile d a me mor a nd um i n opp os iti on to De fe nd a nts ’ mot ion s f or dis c re tio na

ry c os ts on October

26, 2004, arg uing that Dr. Klepper ’s motion wa s untimely and both Def

endants fa iled to demonstrate that the claimed fees were nece ssary and reasonable and were lim ited to fee s char g ed for a ppearing at a deposition or trial.

The trial court enter ed an order on November 12, 2004, awa rding Dr. Klepper $16,830.48 in d isc re tio na

ry c os ts a nd Pr e mie r $ 10 ,2 77 .4 6 in dis c re tio na ry c os ts. Carp e nte r fi le d a ti me ly app e a l. Carp e nte r a sse rt s o n a

pp e a l tha t (1) the tr ia l c ou rt e rr e d in a dmi tti ng the te sti mon y of De fe nd a nts ’

e xpe r tw i t n e s s e s ; ( 2 ) t h e e rr o n e o u s a d m i s s i o n o f D e f e n d a n t s ’ e xp e r t s ’ t e s t i m o n y m o r e t h a n l i k e ly

a ff e c te d th e ou tc ome of the tr ia l; a nd , ( 3) the tr ia l c ou rt e rr e d in a wa

rd ing c e rt a in d isc re tio na

ry c os ts to D e fe nd a nts

.

A trial court has broad discretion in de termining the “admissibility , qualifica tions, relevanc y and compe tency

of expert testimony .” McD aniel v. CSX Transp.
, 9 5 5 S.W .2d 257, 263 (Tenn.1997)

. Questions reg arding the qualifica tions of expert witnesses are left to the trial court’s discretion and may be overturned only if that discretion is abused. McD aniel
, 955 S.W .2d at 263. The Te nnessee Supreme Court has de fined a n abuse of discretion t o m ean “ an er roneous c onclusion or judg ment on th e p ar t of the trial judg e – a c onclusion that was cle arly ag ainst logic (or r eason) and not justified.” Foster v. Amc on Int’l, Inc

. , 621 S.W .2d 142, 145 (Tenn.1981)

. Carpente r first conte nds that Defe ndants’ experts, Drs. Aa ron and D eMar ia, fa iled to meet the re qu ir e me nts of

Te nn e sse e Cod e An no ta te d, se c tio n 2 9- 26 -1 15 , w hic h s ta te s in pe rt ine nt p art :

(a) I n a malprac tice action, the claimant shall have the burde n of proving by evidenc e as provided by

subsection (b):

(1) The rec og nized standard of acc eptable pr ofessional pra ctice in the pr ofession and3

the spec ialty

there of, if any , that the def endant pr actice s in the community in which the def endant pr actice s or in a similar community at t h e time the alleg ed injury or wrong ful ac tion occurr ed;

(2) Tha t the defe ndant ac ted with less t h an o r fa i l ed to ac t with ordinary and

rea sonable c are in acc ordanc e with such standa rd; and

(3) As a proxi mate result of the defe ndant' s neg lige nt a ct or omission
, t h e p l aintiff suffe red injuries w hich would not otherwise ha ve occ urre d.

Tenn.Code Ann. § 29- 26-115.

Carp e nte r a

rg ue s th a t D r. Aa

ro n w a s n ot q ua lif

ie d u nd e r the loc a lit y

ru le beca us e his knowledg e of the applicable standard of car e wa s based solely

on his famil i ar i ty

with statewide

acc reditation standar ds in Kentucky hospitals. Tenne ssee Code A nnotated, sec tion 29-26-115(a )(1) require s that a patient’s e x pert in a me dical malpra ctice c ase ha ve knowledg e of the stan dard of profe ssional prac tice in the community wher e the de fenda nt phy sician pra ctices or in a similar

c o mm u n ity

. R o b i n son v. LeCorps , 83 S.W .3d 718, 724 (Tenn.2002) . “[I ]t would seem rather difficult, if no t impossibl e, to know the standa rd of c are in a community without having a ny knowledg e of the community i n q u estion.” Sandlin v. University M edical Center , No. M2001- 00679-COA-R3-CV, 2002 WL 1677716, at *6 (Te nn.Ct.App. J uly 25, 2002 )

. T h is Co u r

t d e termi n ed th at a rea so na

ble ba sis fo r a n e xpe rt ’s kn ow le dg e of the me dic a l c omm un ity

in q ue sti on c ou ld consist of information such as t h e s i ze, location, and pre sence of tea ching hospitals in the community

. Sa nd lin , 2002 WL 1677716, at *6. During direc t e x amination, Dr. Aa ron testified a s to the nu mbe r of be ds a t the Cla rk sv ill e ho sp ita l, the me dic a l te c hn olo g y a va ila ble , a nd the pr oximi ty of the c ity to a la rg e r m e tr op oli ta n a

re a . Cle arl y , Dr . Aaro n’ s te sti mon y e sta bli sh e d th a t he ha d s ome knowledg e as to the me dical community in Clarksville.

Howeve r, it is less clea

r whether Dr. Aar on established that he ha d knowledg e of the standard of pr of e ssi on a l pra c tic e in a co mmu nit y sim ila r t o Cl ark sv ill e . E xpe rt s mu st g o f urthe r tha n s imp ly

asserting that they

are familiar wit h t h e applicable standa rd of c are

. Mabon v. J

ackson- Madison County Gen. Hosp. , 9 68 S.W. 2d 82 6, 83 1 ( Te nn .Ct .A pp.1 997) . E xpe rt s mu st p re se nt f a c ts demonstrating how they have knowledg e of the applicable standard of profe ssional car e in a similar community

. Spangler v. East Tenn. Baptist Hosp.
, N o

. E 1 9 9 9

- 0 1 5 0 1- CO A

- R3

- CV
, 2 0 0 0 WL 222543, at *1-2 (T enn.Ct.App. Fe b. 28, 2000). Dr. A aron w as admittedly unfamiliar with the standard of

car e in Clarksville, having prac ticed solely in L ouisvill e, Ke ntucky . He a sserted tha t he was, howe ver, “ intimatel y ” f am i l i arwi t h t h e s t an d ar d o f p ro fe s s i o n al p ra ct i ce i n co m m u n ities simi lar to Clarksville, having serve d on a fe dera lly mandated me dical ca

re qua lityassura nce c ommitt ee f or the state of K entucky

which collec ted statistical information from p a r ti c ip ati n g h o s p it a ls a nd medical reg ions throughout the sta te, some of whic h had communities similar t o C l ar ksville. Dr. Aar on testified:4

Q. What c ommuniti es in K entucky from a medical standpoint are similar to Clarksville that y ou’re familiar with? A. Well, the hospital in Hopkinsville is the same size. Owensboro, one of the smaller

Paducah hospitals, Shelby v i l le or L exington hospitals are this size. Th e re are c omm un ity

are a s a nd mos t of

the sc ho ols that us e d to be i n th e L VC

. Bow ling Gr een ha s a hospital t h at size. Richmond has a hospital that siz e, similar siz e, similar communities, and I ’m intimately awa re of wha t went on - wha t goe s on on a day -to-day basis in the pra ctice of medicine in a c ommunitylike this and simil ar

c omm un iti e s.

Ho we ve r d ur ing vo ir

dir e , D r. Aa

ro n r e ve a le d th a t he ha d no p ri vil e g e s in a ny of the ho sp ita ls which he ha d mentioned, nor ha d he lived in any of t he cities he listed since he ha d been a medical doctor, nor ha d he eve r treated a pa tient in any fac ility in the cities he listed. D r. Aa ron testified that he had ope rate d in the Russell Count y and Ada ir County Hospitals, w hich are 100-bed hospitals, but that h i s l as t o pera tion in thos e hospitals was seve n or eig ht y ear s ag o. Dr. Aa ron wa s then questioned as to how he had knowledg e of the standard of car e in the se communities w hen he ha d

never prac ticed in them. Dr. A aron te stified:

Q. Th e jo b y ou ha ve wh e re - h ow didy ou be c ome fa mil iar w ith the se ho sp ita ls a nd that th e y ’r e lik e in B ow lin g Gr e e n, Ho pk ins vil le
, a nd Ow e ns bo ro ? Di d
y ou g o out on the I nterne t and look them up? A. No, I

didn’t. I told y ou, for four y ear s eac h participa ting hospital and medical r eg ion in the state of K en t ucky submitt ed statistical information to the committee which I

chair ed. Q. Well, did t hey submit i nformation about what their standar ds of ca re

w e r e f o r s u r g e r y? A. No , they

didn’t. I happene d to be awa

re of what their standa

rds of

car e ar e for

surg ery if they are acc redited, a nd those hospitals are a ccr edited. Q. An d h ow do y ou kn ow wh a t th e ir sta nd ard s o f c are are fo r s ur g e ry if they are acc redited? A. I ’m aw ar e o f t he joint commission on accre ditation’s policy and standards f

or ac cre ditation. Q. Wel l, d oe s th a t g e t a s d e ta ile d a s say in g wh eth e r y ou ne e d to c los e troca r sites in a lapa

roscopic ve ntral her nia proc edure ? A. No, it doe s not, a nd I don’t know any hospital that has either policy

or pr oc e du re that st a te s th a t. Q. All right. So y ou wouldn’t know from y our job what the standa rd of

car e wa s in these communities was as f ar a s whether

surg eo n s cl o s e t roca

r sites or did n’ t c los e tr oc ar s ite s? A. No, that’s not cor rec t. I do know what the sta ndard of car e for closure of t r o c ar s i t e s w o u l d b e i n a n y a c c r e d i t e d i n s t i t u t i o n i n K e n t u c k y b e c a u s e I a m a surg eon. I ’m familiar w ith those standards and I know how they

are applied. Q. That’s wha t I ’m try ing to f ind out, Doctor.5

A. Well, I ’m answe ring y ou the best I can. Q. Other than knowing that they meet the standa

rds for a ccr editation and other than knowing the statistics about them, how do y ou know what the
sta nd ard s a

re fo r s ur g e on s in tho se c omm un iti e s a s f ar a s c los ing tr oc ar s ite s? A. Standards are established much as words in the Eng lish lang uag e ar e established, by

usag es and by

continuing me dical educ ation.

“F or the purpose of Tenn.Code Ann. § 29-26-115( a), the only rele vant ‘c ommunity ’ is the communi t y i n the which the de fenda nt phy sician ac tually prac tices or in a similar c ommunity .” Kenyon v . Handal , 1 22 S.W. 3d 74 3, 76 2 ( Te nn .Ct .A pp .2 00 3) . “ Ac c or din g ly , th e c ou rt s h a ve he ld that me dic a l e xpe rt s te sti fying for a pa tie nt i n a me dic a l ma lpr a c tic e c a se ma y no t ba se the ir testimonysolely on their fa miliaritywith a national standa rd of pr ofessional pra ctice.” Kenyon , 122 S.W .3d at 762. Nor may expert testimonybe base d on a statew ide, Totty v. Thompson , 121 S.W .3d 676, 678-79 (Te nn.Ct.App.2003), or eve n a re gi o n al s tandar d of prof essional pra ctice. Howell v. Baptist Hosp. , No. M2001-02388-COA- R3-CV, 2003 WL 112762, at *8 (Te nn.Ct.App. J an. 14, 2003).

Dr

. Aa

ro n’ s te sti mon y fa ile d to de mon str a te that his op ini on re g ard ing th e appl ic able standard of profe ssional prac tice wa s based on his knowledg e of the standard of profe ssional prac tice in a c omm un ity

sim ila r t o Cl ark sv ill e . D r. Aar on a sse rt e d th a t he wa s “ int ima te ly ” fa mil iar w ith hospitals of simil ar size and with similar communities as Clarksville, howeve r, the only basis that h e as s er t ed for suc h knowledg e wa s his posit ion as the cha irman of the K entucky medical c are quality assura nce c ommitt ee. He co ncede d that the information provide d by the participating ho sp ita ls a nd me dic a l r e g ion s d id n ot i nc lud e the s tan dard of c are fo r the ind ivi du a l in sti tut ion s. Fur thermo r e , h e a

p p e ar e d to b a s e h is k n o w le d g e s o le ly o n n a ti o n a l a c c r e d it a ti o n s ta n d ar d s r a th er t h a n o n p e r s o n a l e x p e r i e n c e s u c h a s e x e r c i s i n g p r i v i l e g e s a tt h e h o s p i t a l i n t h e r e l e v a n tc o m m u n i t y, sp e a kin g wi th o the r s ur g e on s in the re le va nt c omm un ity abo ut the sta nd a

rdof c are in the ir

c omm un ity , o r thr ou g h r e fe rr a ls.

Al tho ug h D r. Aa

ro n te sti fi e d th a t he ha d treat e d p a tie nts fr om c omm un iti e s si mil ar t o Clarksville, he further stated that his car e of those patients was no diffe rent than the car e he pr ovided to his reg ular pa tients in L ouisvill e. Dr . Aar on testified:

Q. Did y ou ever have patients – reg ular pa tients – surg ical patients that saw y ou in a community

simil ar to Clarksville? A. No. B ut I saw many

from ar eas similar to Clarksville. Q. Wel l, the pa tie nts wo uld c ome a nd the y wo uld c ome to L ou isv ill e to g e t tr e a tme nt the re ; is that c or re c t? A. Cor

re c t. Q

. A n d yo u t r e a t e d t h e m –w h e n yo u p r o v i d e d t h o s e p e o p l e w i t h s u r g e r y, it did n’ t ma tte r to y ou if

the y we re fr om L ou isv ill e or

fr om O xfor d, Mis sis sip pi, did it? A Cor

re c t.6

Q. So where they wer e fr om didn’t make any differ ence in terms of the

c are y ou g a ve the m? A. Correc t.

Take n in its entire ty , Dr. Aar on’s testimony fails to e stablish the ne cessa ry elements of the simil ar loc ality

rule.

Carpente r also asse rts that it was err or for the tri al co u rt t o admit the testimonyof Dr. DeMa ria pursua nt to the locality rule. Car

penter first claims that Dr. D eMar ia fa i l ed t o meet the

re qu ir e me nts of

the loc a lit y

ru le be c a us e he ha d n ot p ra c tic e d s ur g e ry in a c omm un ity

sim ila r t o Cla rk sv ill e in o ve r a

y e ar p ri or

to C arp e nte r’ s su rg e ry . While the loc a lit y ru le re qu ir e s a n e xpe rt

to have “ some knowledg e” of the standar d of ca

re in a simil ar community
, it doe s not require that the expert actua lly

prac tice in that community to obtain such knowledg e.

Th e te sti mon y

of Dr . D e Ma

ri a is c ou c he d in gen e ra lit ie s. I t is inc umb e nt u po n th e pa rt y of fe ri ng e xpe rt

te sti mon y

un de r the loc a lit y

ru le to c arry

his bu rd e n o f e sta

bli sh ing the fa mil iari ty of the e xpe rt

wi th the a c c e pta

ble sta nd ard of pr of

e ssi on a l pra c tic e in Clark sv ill e , Te nn e sse e , o r i n

a sim ila r c omm un ity . A s D r. DeM ari a ha d n e ve r b e e n to Cla

rk sv ill e , T e nn e sse e , p ri or to h is testimony , it was nec essary to establish his familiarity with the accepta ble s tandar d of prof

essional prac tice in a similar community . As to this is sue, he te stified on direc t examination:

Q. Dr . D e mari a , a re y ou fa milia r wi th the sta nd ardof a c c e pta ble profe ssional prac tice as it ex isted in November of 2001 in Clarksville, Tennessee , or

a sim ila r c omm un ity , w ith re sp e c t to the pe rf or ma nc e of

a lapa ro sc op ic ve ntr a l he rn ia repa ir? A. I

thi nk I a m, y e s. Q. How ar e y ou familiar with the standa rd of c are ? A. Wel l, d ur ing my te nu re in R ic hmo nd , I ’v e pr a c tic e d in c omm un ity hospitals outside of the city

. I actua lly live in a county outside of Richmond that’s about the same siz e as Montg omery Countyhere

. I ha ve wo rk e d in se ve ra l 20 0- be d - - a pp ro xima te size - - ho sp ita ls i n the Virg inia are a and have done lapar oscopic surg ery in those hospitals on a number of oc c a sio ns

. I ’ve a lso traveled in my role a s a tea cher to numerous communities that are ve ry

sim ila r t o th is i n o the r s ta te s. I ’v e be e n to Wes t V ir g ini a wi thi n th e pa st six, ei g ht mon th. I ’v e be e n to a smal l town in u ps ta te Pe nn sy lva nia se ve ra l ti me s to

a ssi st i n s ur g e ry

a nd to h e lp s ur g e on s w ho wo rk the re to l e arn lapa

ros copic pr oc e du re s. MR. S I M S : Yo ur Honor, at this t ime, we would tende r Dr. Demaria as a n expert in laparosc opic ventra l hernia r epair

.

MR. DOUGHTY : We object. L ack of foundation. THE COURT: Do y ou wish to voir dire on founda tion? MR D OU GH TY : Y e s.7

Dr. De Maria w as chie f of g ener al surg ery and profe ssor of surg ery at the University Medica l College of Virg ini a l o ca t ed in R ichmond, Virg inia. He is a f ellow of the A merica n College of Surg eons and pe rfor ms laparosc opic surg ery at the Univer sityof Virg inia Hospital three da y s per

wee k. The University Hospital is a major medica l center of about 600 be ds serving a metropolitan

are a of some 800,000 to 900,000 pe ople.

Relative t o his familiarity with communities simil ar to Cl arksville, Te nnessee , he testified

on cross e x amination:

Q. Yo u me nti on e d th a t y ou pr a c tic e d in a c ou ple of su bu rb a n h os pit a ls the re a s w e ll a s p ra c tic ing a t th e un ive rs ity ho sp ita l? A. Ye s. Q. I s John so n- Willi s H os pit a l on e of the m? A. Rig ht. Q. And Chippenham Medica l Center? A. Rig ht. Q

. T h o s e ar e b o t h i n C h e s t e r f i e l d C o u n t y? A. Yes, sir. Q. How fa

r ar e they from y our off

ice in – – A. J ohnson-Will is is fairly far out in the county . I t’s probably about 20 miles from downtown. Q. 20 miles from downtown Richmond? A Ye s. Q. Whe n y ou we re pr a c tic ing the re , y ou c on tinued to prac ti ce also in Ric hmo nd . T ha t w a s y ou r m a in j ob – – ri g ht? – – a t th e un ive rs ity ho sp ita l? A. Ye s. Q. I t’s been thr ee or four y ear s s i n ce y o u ’v e p ra ct i ce d at those two fa c ili tie s, ha sn ’t

it? A. Sin c e I

ma int a ine d a n o ff

ic e – – we ha d a n o ff

ic e a t th e c omm un ity hospitals for three or four y ear s and ab an d o n ed that ultimately three or four

y ear s ag o. But I

rema in on the courte sy

staff f or most of the hospitals in the are a. Q. Tell us what y ou know about Clarksville. A What I know about Clarksville is that today is the first time I ’ve be en here
, but it’s a much smaller town obviouslythan Nashville, whic h is where I flew into y esterda y . But that’s a pretty g ood siz e city

. I t took us about 45 minut es to g et here

. I k n o w there ’s information – – I think Dr

. Bla ck had provided a supplement that I

looked at that s ay s t hat Montg omery Countyhas about 135,000 people. I think I m en t i o n ed b ef

ore tha t I know about the hospital, the size of the hospital, its capabilities, and so forth. Q. T el l u s what y ou know about the hospital. Which hospital are y ou t a l k i n g ab o u t ? G a t e w a y? A. Ye s.8

Q. Wha t do y ou kn ow abo ut i t? A. That it’s about 200 or so be ds. They have a n emer g ency

room. They have c ance r treatment. They have most of the sta ndard spe cialties re prese nted. I think they have a bout 150 staff phy sicians with privileg es there

. Q. Which communityare y ou s ay i n g t h at y ou know of that is similar? You have never prac ticed in Clar ksville a nd never

been he re until today . You don’t know any doctors in Clarksville, do y ou? A I

don’t think I

know any

doctors in Clarksville, no. Q. Yo u do n’ t ha ve a ny fi rs tha nd fa mil iari ty wi th the sta nd ardof c are in Clarksville per se , do y ou? A. Since I ’ve be en her e exactly one time toda y , I

don’t have that type of firsthand e x perie nce. B ut I think mypoint was that I have, y ou know, enc ountere d other situations that are very simil ar in both my

own local e nvironment in Virg inia, knowing phy sicians who worked i n smaller hospi tals working with them on a re g ular basis, as we ll as traveling to numerous sm aller hospitals, having a cha nce to de velop rela tionships wit h surg eons, phy sicians. I offe r cour ses at our instit ution. W e have many su rge o ns travel to Richmond wher e we have se vera l day s of intera ction, and so forth. Q. Tell me the na me of a community

y ou say is simi lar to Clarksville. A. Meaning a town? Q

. A c o m m u n i t y. A. I

th in k I me n ti o n e d my

c o u n ty a s b e in g s im il ar

to M o ntgome ry Cou nty , w hic h I

un de rs ta nd wh e re Cla

rk sv ill e is. We h a ve tow ns wi thi n o ur c ou nty in the county

of Hanove r, Virg inia, which is w here I live. Mecha nicsville is the town that I live in. Q

. D o yo u p r a c t i c e i n H a n o v e r C o u n t y? A. I

don’t have an off

ice in Ha nover. Q. Do y ou ha ve pr ivi le g e s a t a ho sp ita l? A

. I h a v e c o u r t e s y p r i v i l e g e s a tt h e h o s p i t a l i n H a n o v e r C o u n t y. Q. Ho w b ig is tha t ho sp ita l? A Th a t h o s p it a l i s ab o u t 1 2 0 b e d s , I th in k

. I t’ s c a ll e d N e w H anover Reg ional Medica l Center. Q. You don’t do surg ery there , do y ou? A. No, I don’t. We ha d had an office t h er e t h at o n e o f m y p artners visited very

often up until he left a

bout a y ear

ag o. I did not my self g o out there. Q. What particular community

or town in Hanove r county are y ou say ing i s s i m i l ar ? T h e w h o l e c o u n t y? A No. The town I live in, Mecha nicsville, which is the most populated
t o w n ––I d o n ’ te v e n k n o w i f yo u ’ r e s u p p o s e d t o c a l l i ta t o w n

. It ’ s a

s m a l l c i t y. Q. I s th a t w he re the ho sp ita l is ? A. Yeah. Q. Th e on e that y ou ha ve ne ve r d on e a ny su rg e ry in. I s th a t r ig ht? A. Cor

re c t.9

Q. What other community do y ou say

is simi lar to Clarksville? A. Well, the hospital, J ohnson-Will is Hospital, that I mentioned bef

ore is in, Ig uess y ou would call it a town in Chester fi el d Countycalled Me dlothian. Midlothi an is sort of a ma jor population cente r for

Chesterfie l d co unty

wher e that hospital is located. Q. That’s the hospital y ou said it takes y ou about 20 minutes to ge t there? A

. W e l l
, i t ’ s ab o u t2 5 m i l e s a n d t h e r e ’ s n o h i g h w a y t h a tg o e s t h e r e

. It
t a k e s a b i tl o n g e r

t h a n 2 0 m i n u t e s , u n f

o r t u n a t e l y. Q. I t’ s bee n thr e e or fo ur y e ars sin c e y ou dida ny su rg e ry the re , h a sn ’t

it? A. Yes, sir. Q. Ha s it

be e n c los e r t o f

ou r y e ars ? A. I t’s probably about four y ear s. I run a la parosc opic training prog ram wher e I have three fellows. The y g o out there e very

wee k and wor

k with one of the do c tor s th a t w e tr a ine d a t MC V, wh o I ta lk t o o n a

re g ula r ba sis

. He is ou t th e re fu lltime. Q. L et me ask y ou, the community o f C h es t er fi el d Countywher e J ohnson-Will is is and Chippenham, that c ommunityhas two hospitals. One of the m is C hip pe nh a m. It ha s 4 66 be ds . I s th a t r ig ht? A. Chippenham Medica l Center? Q. Ye s. A. I think that statistic probably repr esents a c ombination of the two ho sp ita ls. Q. Doesn’t Johnson-W illis Hospital have 282 be ds on its own? A. I know they put a new addition on in the la st two y ear s. That’s pr ob ably e nla rg e d it qu ite a bit

. Q. Wou ldn ’t y ou a g re e the Chi pp e nh a m Ce nte r the re in C he ste rf ie ld Countyis a level 3 trauma ce nter? A. I

su pp os e the y

c a ll t he mse lve s a

le ve l 3 t ra uma cent er. F ra nk ly , it seems to me to be mostly a mar ketin g ploy . I

should comment that Chippenham Medica l Center just opened a new building . I

suspect they h ave a

fair numbe r of beds. I t’s a ca

rdiac surg ery

cente r. I t wasn’t ther e whe n I was working the re thre e, four y ear s ag o. Q. So now that they have e x panded, the y

have a car diac tre atment ce nter there ? A

. T h e y b u i l ta b u i l d i n g f

o r c ar d i a c s u r g e r y. Q. You don’t dispute that they are a leve l 3 trauma c enter ? A. I

g ue ss the y

are . I do n’ t r e me mb er wha t th e definiti on s o f a le ve l 3
tr a uma c e nte r i s. Q. I n any event, it’s been four y ear s since y ou prac ticed at either one of tho se ho sp ita ls, isn ’t

it? A. Ye s. Q. Yo u pr a c tic e no w mos tly a t the te a c hin g ho sp ita l th e re . I s th a t r ig ht? A. Th e va st m a jority of my c lin ic a l pr a c tic e is i n th a t c e nte r, y e s.10 MR. DOUGHTY : Your Honor, we would object to the qu a lif ic a tio ns of

the wi tne ss.

Th e tr ia l c ou rt ov e rr

ule d ob je c tio ns to the qu a lif

ic a tio ns of Dr

. De Ma

ri a un de r the loc a lit y

r u l e a n d a l l o w e d h i m t o t e s t i f y.

Th e bu rd e n o f the pa

rt y offe ri ng te sti mon y

is the sa me un de r the sim ila r l oc a lit y ru le

re g ard le ss o f w he the r the wi tne ss i s o ff e re d b y the pla int if

f o r the de fe nd a nt. I n this c on te xt, th is Court has held:

I t is the plaintiff who is char g ed with the burde n of proof as t o the s tandar d of ca re i n t h e c o m m u n i t y i n w h i c h t h e d e f e n d a n tp r a c t i c e s o r

i n a s i m i l ar c o m m u n i t y. T. C.A

. § 2 9- 26 -1 15 (a )( 1) . A pla int if f w ho c ho os e s to pr ov e the sta nd ardof c are in

a sim ila r co mmu nit y ne c e ssa

ri ly mus t pro ve that com mun ity is s imi lar t o th e on e in wh ic h th e de fe nd a nt p ra c tic e s. To sh if t th is b urden to the de fe nd a nt d ir e c tly

c o n t r a d i c t s t h e p l a i n l a n g u a g e o f t h e s t a t u t e a n d w o u l d r e n d e r t h e s t a t u t e a

n u l l i t y. Under the principles of

summary judgme nt, onc e Dr . Thomas moved for summary judgme nt and submitted an aff idavit s tating tha t he complied with the standa rd of

car e in J ackson, the burden the n shifted to Mabon t o set forth specific facts that Dr. T h o m a s f a i l e d t o m e e tt h e s t a n d ar d o f c ar e i n J a c k s o n o r

i n a s i m i l ar c o m m u n i t y.

Mabon , 968 S.W .2d at 831.

Establishing the similarities in communities is as much a part of the burden of proof under the l ocality rule as is establishing that the wit ness practices in a contiguous state. Bravo v. Sumne r Reg’l Health Sys, Inc

. , 148 S.W .3d 357, 368-69 (Tenn.Ct.App.2003). The testimony offe red by Dr. DeMa ria in this case stands in stark contra st to that offe red by Dr. Eng el in Bravo . After testify ing that he wa s a member

o f t h e Tennessee Bur eau of TennCar e Medic al Service s Appea l Boa rd, Dr. Eng el testified:

. . . I

have revie wed g eog raphic al data, sta tisti cal da ta and litera ture

conce rning Gallatin . . . and Sumner Reg ional Medi cal Cente r. I know that in 2000, Gallatin, Tenne ssee ha d a p o p u l ation of approximately

23,230 and that Sumner County had a populat ion of approxi m at el y

130,449. I

know that Sumner Reg ional Medica l Center is a not for

profit fac ility with 155 bed ca pacity with over 700 staff e mploy ees a nd over 100 phy sicians. Sumner Reg ional Medica l Center de livered a

ppro x i m at ely

756 babies in 2001 and tre ats over 25 ,0 00 pa tie nts per y ear

in the ir 24 ho ur a da y Em e rg e nc y

Roo m. Further, Sumner Re gional Medica l Center is 32 miles or approximately

a 4 5

- mi n ute drive f

rom Vande rbilt University Medica l Center, a lead i n g m edica l complex and teaching hospital. Sum ner Cou nty , T e nn e sse e ha s th re e (3 ) g e ne ra l me dic a l su rg ic a l ho sp ita ls.11 Ba sed on this and other information, I am famili ar w ith the medical

resour ces a vailable to the med i cal c ommunityin Gallatin, Sumner County
, Tenne ssee. I am famili ar w ith the standard pr ocedur es and prac tices of obstetric ians in communities sim ilar in size to Gallatin, Sumner County , Tenne ssee.

Bravo , 148 S.W .3d at 361.

Def endant simply

has not ca

rried its burde n of proof

that the out ly ing c ommuniti es nea r Richmond, Virg inia, are simil ar c ommuniti es to Clarksville, Tenne ssee. Dr . DeMa ria doe s not qualify as an e x pert witness unde r the similar loca lityrule, a nd his testimony is not admissi ble.

T h e l e g i s l a t i v e l y

m a n d a t e d “ s i m i l ar l o c a l i t y r u l e ” h a s l o n g s i n c e o u t l i v e d i t s u s e f u l n e s s

. It de ve lop e d a s a n impr ov e me nt o ve r the “ str ic t lo c a lit y ru le ” wh ic h w a s g ro un de d in the ma nif e st ine qu a lit y e xistin g in re mot e his tory be tw e e n phy sic ia ns pr a c tic ing in l arg e ur ba n c e nte rs a nd tho se prac ticing in r emote rur al ar eas. Rapid advanc es in me dical educ ation, means of c ommunication, and both invasive a nd diag nostic technolog y have r ender ed the “ simil ar loc ality ru l e” o f t oday as obsolete as the “ strict locality rule,” which it leg islatively suppla n t ed in 1975. Tot ty , 121 S.W .3d 676.

Th e re is n o b a sis in log ic or re a so n wh y the te sti mon y of bo th Dr

. Aa ro n a nd Dr . D e Ma

ri a is not admissi ble into evidence in this case. We ar e, howe ver, powerless to do any thing other than
to e ng a g e in the te dio us e xer c ise of ha ir -s pli tti ng ma nif

e ste d b oth in this c a se a nd in the re c e nt c a se of Tra v is v . F

e rra ra c c io et

al. , 2005 WL

2277589, No. M2003-00916-COA- R3-CV (Tenn.Ct.App. Se pt. 19 , 2 00 5) . We c a n o nly on c e again fo llo w the le a d o f the Sup re me Cou rt of Te nn e sse e in Robinson , 83 S.W .3d at 723-24, and im plore the L eg islature to rele g ate the “similar l ocality rule” to the “ash he ap” of

history

. Stre e t v . Ca lv e rt , 541 S.W .2d 576, 583 (Tenn. 1976)

.

As bo th e xpe rt

wi tne sse s f

or De fe nd a nts ha ve fa ile d to me e t the re qu ir e me nts of the loc a lit y

ru le , th e jud g me nt o f the tr ia l c ou rt wi ll b e re ve rs e d a nd the case rem and ed fo r a ne w t ri a l on a ll iss ue s.

I n th e int e re st o f j ud ic ia l e ff ic ie nc y , w e wi ll address the oth e r i ssu e s p re se nte d o n a pp e a l, which issues ar e dete rminable from this re cord, in the event that we a re in e rror in excluding either one or both of D efe ndants’ experts under the similar locality

rule.

Rul e 36 (b ) o f the Te nn e sse e Rul e s o f A pp e lla te Pr oc e du re sta te s:

(b ) E ff e c t of Er ro r. A f ina l ju dg me nt from which re lie f i s a va ila ble a nd oth e rw ise appropr iate shall not be set a side u nless, considering the whole r ecor d, err or inv olv ing a

su bs ta nti a l ri g ht mor e pr ob ably tha n n ot a ff e c te d th e jud g me nt o r w ou ld

re su lt i n p re

jud ic e to the jud ic ia l pr oc e ss.12

Tenn.R.App.P. 36(b).

There is lit tle prac tical diffe renc e betwe en the testimony of Dr. A aron a nd the testimony of Dr. DeMa ria in this case

. Appellee s assert tha t sinc e the testimony is essentially

cumulative, if one

e xp ert ’s testimo ny

me e ts the loc a lit y

ru le a nd on e do e s n ot, the re su lti ng e rr or in a dmi tti ng int o evidenc e the testimony

of the non-qua lify ing e x pert is har mless error

. Appellant takes the vie w that while the re sult re ache d by eac h of the experts is the same, their re asoning and methodolog y differ and we are not dealing with cumulative testimony . Such question require s car eful a n al y s i s o f the
te sti mon y of bo th p hy sic ia ns

.

“I t is well established that if er roneously ad m i t t ed evidence is mer ely cumulative of othe r evidenc e pre sented in the c ase, its admission does not constitute reve rsible er ror.” State v. Torres
, 8 5 8 A. 2 d 7 7 6
, 7 9 2 (C o n n

. C ri m

. C t

. Ap p

. 2 0 0 4 ) ( ci t i n g State v. Calerdon
, 82 Conn.App.315, 326, 844 A.2d 866, ce rt. denied, 270 Conn. 905, 853 A.2d 523 ( 2004)). However , “[w]hi le the er roneous admission of cumulative evide nce c an be harmless, ‘harmless e rror ’ is a more difficult ca se to make when the te stim o n y i s n o t t h at of a fac t witness, but inst ead is e x pert testimony .” Tetrault v. Fa irc hil d , 799 So.2d 226, 228 (Fla.D ist.Ct .App.2001).

I n Durflinger v. Artiles , 7 27 F .2 d 8 88 (5 th Cir .) , d e c e de nts ’ h us ba nd a nd father br ou g ht a

wr on g fu l de a th a c tio n a g a inst the h os pit a l a nd ph y sic ia ns wh o p art ic ipate d in the de c isi on to discharg e a patient who there afte r killed plaintiff’s wife and son. De fen d an t s ch all eng ed the tria l

co u r t’ s a d mi s s io n o f

th e d e p o s it io n o f

D r

. M o o r e , th e d ir e c to r

o f th e M e n ta l H e a lth I n s ti tution char g ed with eva luating the patient, claiming that the testimony was ba sed on fa cts not within Dr. Moore’ s persona l knowledg e. Durflinger , 7 27 F .2 d a t 89 2. Th e c ou rt fo un d th e a dmi ssi on ha

rm le ss

er ro r, i f a n y , s t at i n g:

The re cord is not clea

r whe ther Dr . Moore wa s an expert wi tness or mere ly a lay witness to certain fac ts a t issue in the case . The standa rds applied to lay

and expert witnesses diffe r.

... I n th e ir br ie f, de fe nd a nts su g g e st tha t D r. Mo or e is t o b e tr e a te d a s a n e xpe rt . I f this is so, then his c onclusions ba sed in pa rt on data a nd reports prepar ed by Dr. Strang e, a psy chologi s t co l l eag ue, in re aching a conc lusion on [ the patient’s] condition and pr og no sis wa s p ro pe rl y

in e vid e nc e . H e c ou ld a nd didre a so na bly rel y on thi s information in forming his professional opinion. A i r c ra sh
, 684 F .2 d a t 13 14 (9 th Cir

. ) ( e xp e r t p e r mi tt e d to te s ti f y o n p il o t c o mp e te n c e b a s e d o n f li g h t t r a ining

rec ords).

I f Dr. Moor e ser ved as a lay witness, the depositio n t es timonyshould have be en limit ed to his conclusions based on his own observations. The conclusions based on Dr. Strang e’s obse rvations should have be en ex cluded. This possible err or in the trial judge ’s ruli ng , howeve r, does not require reve rsal of this case

. “Eve n if there is error
,13

re ve rs a l is app ro pr ia te on ly if we c a n s a y

that th e e rr or a ff

e c te d the su bs ta nti a l r ig hts of the pa rties.” Ai rc ra sh
, supra at 1313; F ed.R.Civ.P. 61. No substantial rig hts were aff ecte d by this alleg ed er

ror. Dr

. Strang e testi fied at trial on the same issue a s Dr. Moore’ s deposition testim ony ... The e vidence challenged h ere was c umulative at worst, and did not substantially damag e def

endant’ s case

. Durflinger , 727 F.2d a t 892-893.

I n Car r v . I

ng le , 395 P.2d 65 0 (O k l a.1964), an automobile passeng er br oug ht an ac tion ag ains t t h e o wn er of a truc k and the insure r for injuries sustained to her ne ck and spine when the automobile in which she wa s riding w as struck by the truck. D efe ndants arg ued that the tria l court

er red in the a dmission of incompetent medical testimony . Finding that the admission constituted only harmless e rror , the court stated:

Next, the defenda nts complain the trial court erre d in the admission of incompetent medica l testimony . The trial court permitted in plaintiff’s c ase in c hief pla int if f’ s c ou ns e l to a sk

qu e sti on s o f D r. M, a nd os te op a th a nd a sp e c ia lis t in orthopedic and neurolog ical surg ery , which wa s based upon a medical book by

Dr. Reed Catlett, M.D., Professor of Medicine, University of Southern California . The g ist of wh a t w a s r e a d w a s th a t a pat ien t with a ‘h e rn ia te d lu mba

r d isc pr e se nts a history of pain running down hi s leg orig inating either in t he re g ion of the low bac k or other lowe r extremities.’ The re ading continued in s u b s t an ce w as further to the ef fe ct ‘t h e p ai n wa s d u e t o n er v e i rr i t at i o n an d t h e s en s at i o n i s re fe rr ed d o wn t h e l eg,

us ua lly dis tr ibu te d in the po ste ri or thi g h, the cal f, he e l a nd int o th e toe s. ’ T o th is

rea ding D r. M ag ree d such would be the case . He c ould hardly do otherwise sinc e his testimonywas in all particulars substantially identical to the matter rea d form the bo ok . T he vic e of

thi s p ro c e du re is r e a dil y

app are nt. F ro m a

le g a l st a nd po in t it is

ra n k h ea rs ay p ro d u ce d b y co u n s el fr o m an au t h o r’ s av ai l ab l e t ex t b o o k an d t h ro u gh the me diu m of

int e rr og a tio n h e thu s pre se nts the te sti mon y of the a uth or g ive n a s it

was wr itten, without the particular situation in mind or the sanction of an oath, a nd without the vouchsafe d author bei n g l iable to cr oss examination, i n denial of the pr e c e de nt ri g hts of se qu e str a tio n of the auth or a s a wi tne ss a nd c on fr on ta tio n o f h im fr om the wi tne ss sta nd . F or the se re a so ns a nd oth e r r e a so ns the tr ia l ju dg e e rr e d in pe rm itt ing c ou ns e l f

or pla intiff to read to h is d oc tor , o r a ny do c tor app e ari ng a s a witness, from the textbook in question. 32 C .J .S. Evidence § 718, note 94, p. 628.

I n this connection, howe ver, the rec ord di scloses t hat not only Dr. M testified for the plaintiff in keeping with the text materia l, but Dr. P. W did also, in substance.

Dr. F . B’ s testim o n y for the pla intiff was in kee ping w ith the tex t rea d from to the eff ect that a displaceme nt of the disc material cre ates dire ct pre ssure on the spinal

co rd
, an d n e rv e r o o t s , gi v i n g s y m p t o m s o f p ai n an d n u m b n es s d o wn t h e l eg. Moreove r, Dr. Mc D for the defe nse, on cr oss examination, t estified in s ubstance that14

a ru ptu re d in te rv e rt e br a l di sc a s a re su lt of tr a uma pu ts pr e ssu re on the ne rv e ro ots , leading into the lower e x tremitie s re sulting in a numbness ther eof, a s the result of

e ith e r a c ute or c hr on ic tr a uma , wi th a wa sti ng a wa y in the low e r e xtre mit ie s. I n th is

connec tion, Dr. P. W specific ally testified that he found the left ca lf of Mrs. I ng le’s le g to b e ‘o ne -h a lf

inc h s ma lle r tha n th e ri g ht. ’ H e a lso te sif ie d th a t Mrs. I ng le

c omp la ine d of low e r ba c k pa ins a nd pa in in the low e r e xtre mit ie s. Th e re c or d h e re in conclusively

shows that the matter r ead f rom the text was cumul at i v e and was not

reve rsible er

ror, unde r Clinton & O. W. Ry

. Co. v. Dunlap, 75 Okla.64, 181 P. 312, h o l d i n g:

‘Wh ile the re are so me a uth or iti e s to the c on tr ary , w e a g re e that,

acc ording to the g rea t weig ht of authority , this method of examination

was improper, and the excerpts from the te x t were inadmissible, but

ou r e xami na tio n o f the re c or d disc los e s tha t this ev ide nc e wa s me re ly cumulative.’

We are , there fore
, in the final analy sis, of the opinion this t estimony , under the conditions here in presente d, while err or, was not injurious under the conditions exis ting in this case . I t has bee n repe atedly held by all authorities t hat er

ror without injury is not rever sible.

Car r , 395 P.2d at 653-654.

I n order to determine w hether

Dr. Aa ron and D r. De Mari a’s testimonies wer e cumulative,

we mus t c omp are the ir te sti mon ie s on the de te rm inativ e iss ue s in thi s c a se

. Th e re we re e sse nti a lly four issues that Appe llees’ e x pert phy sicians testified as to, including whether the leng th of the surg e r y v io late d th e s ta n d ar d o f

c ar e , w h e th e r

th e d e c is io n n o t t o c o n v e r t t o a n o p e n p roce dure violated of the standa

rd of c are , whether

Dr. Kle pper had adequate visualization t o proce ed with the surg ery lapar oscopica lly , and whe ther the s t an d ard of car e re quires surg eons to close a ll 10- milli meter troc ar sites.

Wit h reg ard to the le ng th of the surg ery , Dr. Aa ron testified:

Q. All rig ht. L et’s talk about some standa rds of car e. Dr. B lack, the pla intiff’s expert – the plaintiff’s witness, ha s offe red the opinion tha t Dr. Kle pper de viate d f ro m th e sta nd ard of c are be c a us e of the le ng th o f t ime inv olv e d in the surg ery . Are y ou awa re of that opinion? A. I a m. Q. Do y ou ag ree with Dr. B lack’ s opinion? A. No , I

do n’ t a g re e wi th h im. Q. Why

no t? A. Be cause some things take long er tha n others. The measure ment of time and how long things take does not in any way rela te t o the quality of the outcome

.15 I t’s a mea surable thing . There is not indi cation fr o m m y re view of the opera tive re p o rt that time was a f actor – a dele terious fa ctor in any part of what we nt on in the opera ting r oom or what ha ppened la ter.

Dr

. De M ar i a a l s o t es t i fi ed as t o t h e l en gt h o f t h e s u rge rys t at i n g:

Q. Okay . Fa ir enoug h. L et m e ask y ou about t he length of this surge ry . I s the fac t that this l apar oscopic proc edure went on for 11 hours a de viation from the standar d of ca

re? A. I don’t think it was a deviation, no. Q. What is t he appr opriate le ng th of a lapa roscopic ve ntral her nia re pair? A. Th e le ng th of the su rg ic a l pr oc e du re re a lly de pe nd s on the c ard s y ou ’r e de a lt

as t h e s u rge o n d o i n g t h e o p er at i o n

. P ro ce d u re s ca n b e s h o r t erwh en t h i n gs g o w e ll a nd the y ’r e e a sy a nd lon g e r w he n th e re are tec hn ic a l c ha lle ng e s. Th a t ’ s n o ts o m e t h i n g t h a t ’ s u n i q u e t o l ap ar o s c o p i c s u r g e r y , t h a t ’ s jus t

s u r g e r y. I think – in myexperience , it us u al l y t akes a couple of hours to do a lapar oscopic he rnia re pair like a n u m b i l ical hernia. B ut when thing s g et difficult, it can take longe r.

Dr. Aa ron’s testimonyalso included his opinion about Dr. Kle pper’ s decision not to convert to an open pr ocedur e. Dr . Aar on testified:

Q. Dr. B lack ha s sugg ested that beca use of – Dr. Bla ck opines that Dr. Kle pper de viate d f ro m th e sta nd ardof car e fo r C lark sv ill e by fa ili ng to c on ve rt

thi s proce dure to a n open proc edure . Do y ou ag ree with Dr. B lack? A. No , I

do no t. Q. Why

no t? A. Th e re are no se t g uid e lin e s o n th is. I t’ s a ma tte r o f s ur g ic a l ju dg me nt a s to when to do any

of these thing s. I t’s alway s a possibilit y in a surg eon’s mind that when y ou weig h the risks and the be nefits of a ny situation at any

point in t ime y ou ha ve to c on sid e r tha t. A nd I re a d in his op e rativ e re po rt no te wher e he me ntioned that, that he considere d that at ce rtain points but felt that for the patient’s benef

it whi ch would be tha t when the wor k was done she could basica lly

not have a ll the m orbidity
, the s ickness, and things a ssociated wi th a n o pe n p ro c e du re , a nd he wa s – tr y ing to a vo id tha t.

Dr

. De M ar i a’ s al s o t es t i fi ed as t o t h e de ci s i o n n o tt o co n v er tt o an o p en p ro ce d u re , s t at i n g:

Q. Do c tor , d o y ou qu e sti on or a sc ri be a ny bla me to Dr . Kle pp e r’ s ju dg me nt i n not converting to an ope n proce dure he re? A. No. Q

. T e l l u s w h y.16

A. Well, the risks of open conve rsion are n o t neg ligible he re. We’vealre ady
ta lke d a lit tle bit abo ut i nf e c tio n. We’ ve ta lke d a

bo ut h ow do ing a n o pe n is not a, y ou know, we’ ll be done in 20 minutes approa ch. I t’ s go i n g t o take basica lly starting over in some wa y s to ge t this case done.

Whether Dr. Klepper

had enoug h visualiz ation to proce ed lapa roscopica lly

was a lso an issue in the case to which Dr. A aron te stified:

Q. I n y our re view of the rec ords or a ny of the de positions, i s there a ny – is there any thing in those re cords whic h g ives y ou the opinion that Dr . Klepper ever pr oc e e de d w ith the su rg e ry wh e n h e wa s n ot a

ble to se e wha t he ne e de d to sew? A. No. And in the nurse s’ depositions that I rea d ther e was no indication that any body else who ha s a re sponsibili ty to be a patient a dvocate ever noticed any thing like that ha

ppening during the oper ation.

Dr

. De M ar i a a l s o t es t i fi ed as t o t h i s i s s u e, s t at i n g:

Q. Did y ou see a ny

evidenc e that Dr . Klepper opera ted when he could not see? A. My

opinion is t hat a gr eat amount of t he time re quired for this procedur e wa s in fac t, waiting; wa iting to see a dequate ly and to be sure injury

didn’t occur

. That’s a ppropriate lapar oscopic tec hnique. Q. Did y ou see a ny

evidenc e that he pr ocee ded whe n he could not see ? A. No.

The fina l issue in the case was whe ther the standa rd of care in Clarksville require d surg eons to close all 10-millimeter troca r sites. As to that issue, Dr. Aa ron testified:

Q. Do c tor , d oe s th e sta nd ard of c are fo r C lark sv ill e or a sim ila r t ype c omm un ity

r e q u i r e a g e n e r a l s u r g e o n t o a l w a y s c l o s e a 1 0

- m i l l i m e t e r

t r o c ar s i t e ? A. No , it

do e s n ot. Q. Ca n y ou e xpla in t o th e jury un de r w ha t c ir c ums ta nc e s y ou do n’ t? A. I wo uld sa y wh ile the re is s ome jud g me nt – c lin ic a l ju dg me nt i nv olv e d in it, that most people in simil ar circumstanc es, si milar community have le arne d
t h a tw e n e e d t o c l o s e t h i n g s w h e r e o n l y o n e l a y e r –o n e l a y e r

i s i n v o l v e d

. If
y ou g o throug h the side with an instrument, y ou g o throug h three differ ent muscle lay ers, a nd believe me , we’ re be autifully and wondr ously

made b y our

make r. An d it ’s muc h li ke a lap s tr a ke or

much like the lin ing s o n s te e lbelted ra dials. You’ll have the g rains going one wa y in one muscle lay er a nd the next mus cle lay er is like that and the n the next mus cle lay er is at the right ang le to those. So on our flank just a l ittle over on the s ide t hese 10 mil limeter troca rs wer e put, it’s an automatic prote ctive mec hanism that when those things close like17 that a nd tho se c los e lik e that a nd the n th e oth e rs c los e lik e that, tha t or din ari ly a suture is not re quired. It’s not like y ou’ve g ot a Swiss cheese hole all the way throug h that y ou can se e they close.

Reg arding the same issue, D r. De Maria te stified:

Q. L et’s talk about with re spect to a pa tient l i k e M s

. C arpe nter with the equipment to y our knowledg e that was used by Dr. Kle pper. What would the
sta nd ardof

c are re qu ir e re g ard ing c los ur e of 10 -m ill ime te r t

ro c ar s ite s? A. My

view is that the standar d of ca re doe s not m an d ate closure of 10-

m i l l i m et er troc ar sites. It depends whe re the y are in the abdomen. Tr ocar sites placed out late rally

in the abdomen out to the sides or w ay up near the top of the abdome n usually don’t have to be closed. The t rajectory of the
troca r insertion has to do with whethe r or not y ou need to c lose the site. I n other wor ds, this abdominal wall in this patient was very thick. There was

a lot of space betwee n the skin a nd the inside abdomen. Well, if y ou put y our troca r straig ht at a straig ht ang le right throug h that, then y ou’re g oing to have a short distance and theor etically more c hance for he rniation.

... Q. I think y ou just said that the s tandar d of care does not require closure of 10- mil lim e te r t

ro c ar s it es pl ace d to wa

rdthe ou tsi de or

la te ra lly fr om the be lly button? A. Rig ht. Q. Okay . What’s y our u n d erstanding a bout where the 10-millimeter troca rs

wer e plac ed in this case? A

. T h e y w e r e o u tl a t e r a l l y. Q. Why , when a

10-millim eter

troca r site is out laterally
, does it not need to be closed? A. B e c a us e the a ng le int o the abd ome n is us ua lly su c h th a t th e abd omi na l w a ll collapses on that tra ct that’s cr eate d rathe r than lea ving the trac t open. Q. Can y ou explain that a little more? Does it ha ve to do with the musculature or the – A. I t has to do with the skin location of the incisions ver s u s wh ere the troca r actua lly enter s the abdominal ca vity

. I n other wor ds, the furthe r that distance is, the more ang led the insertion, the more tang ential, the more – when y ou pull it out, the lay ers tend to c ollapse upon themselves and ma ke herniation

mor e dif fi c ult

.

I t is c le ar that the te sti mon ie s of Dr

. Aa ro n a nd Dr . D e Ma

ri a we re e sse nti a lly

ide nti c a l a s to the pertinent issues in the case. T here fo re, if one of De fenda nts’ expert’s testimony meets the locality rule, a n d o n e d o es not, the resulting err or in admitting into evidenc e the testimony of the non-qualify ing e x pert would be harmless e rror

.18

The fina l issue Carpente r raises on appea l conce rns whethe r the trial c ourt err ed in the aw ard of ce rtain discre tionary costs to Def endants. Pursuant to Rule 54.04(2) of the Tenne ssee Rules of Civ il Pr oc e du re , a tr ia l c ou rt ma y a wa rd a pa rt y wh o pr e va ils in l iti g a tio n r e imb ur se me nt f or c e rt a in

enumer ated c osts, including “ rea sonable a nd nece ssary court re porter e x penses f or depositions or
tr ia l, [a nd ] re a so na

ble a nd ne c e ssa

ry e xpe rt wi tne ss f e e s f or de po si tions or

tr ia ls. ” Te nn .R. Civ .P. 54.04(2). The party

see king to r ecove r discre tionary costs bear s the burden of demonstrating that it is entit led to rec over suc h costs. S ta ls wo r th v

. G r u m m ons , 3 6 S.W .3d 832, 835 (Tenn.Ct.App.2000). Such a war ds should be upheld on appe al so long a s the trial court applied the

corr ect leg al standar d and re ache d a dec ision that is not clea rly unrea sonable. Bogan v. Bogan , 60 S.W .3d 721, 733 (Tenn.2001)

. Howeve r, the party challeng ing the awa rd on appea l ha s the burden of showing how the t ri al court a bused its discretion. Sanders v. Gray , 989 S.W .2d 343, 345 (Tenn.Ct.App.1998).

T h is Co u r t n o te d in Ma s s

. Mut. Life Ins. Co. v. Jefferson , 104 S.W .3d 13, 36 (Tenn.Ct.App.2002), tha t proce eding s involving discre tionary costs are primarily

deter mined on the aff idavits and arg uments of counsel in light of the e ntire re cord, a nd evidenc e bey ond the competing aff idavits is rarely

prese nted during the hea ring . The Court we nt on to state:

[F]ul ly develope d rec ords of contested procee dings involvi ng costs under Te nn. R. Civ. P . 54.04(2) a

re r are and ar e ce rtainly

not require d to enable the trial court, or an appe llate court for that matter , to review a cla im for discre tionary costs. I n case s wher e the issue of

discretionary

costs has been decide d on aff idavits a nd the re cord of the e nti re pr oc e e din g wi tho ut the pr e se ntatio n o f n e w e vid e nc e sp e c if ic a lly pe rt a ini ng to the dis pu te d c os ts the mse lve s, the tr ia l c ou rt ' s d e c isi on c a n e ff e c tiv e ly be r e v ie w e d w ith o u t a tr a n s c r ip t o f th e h e ar in g o n th e T e n n

. R. Ci v . P. 54.04(2) motion. According ly , parti es challeng ing a trial court' s decision re g arding discretionary

costs are not nece ssarily require d to submit a transcript of t he hea ring on discretionary

costs in order to r aise the issue on a ppeal.

Other panels of this court have held that they will presume that the e vidence supports a trial court's de cision reg arding discretionar y costs in the ab sence of a
transcr i p t o r re cord of

the hea ring on discretionary

costs. Luna v. Breeding, No. M2000-01932-COA- R3-CV, 2001 WL 950187, at *3 (Te nn.Ct.App. Aug .22, 2001) (N o Te nn

. R.A pp

. P. 11 app licat io n fi le d) ; Fa ux v . S pe ar s, No. 03A01-9312- CV00 43 3, 19 94 WL

14 78 30 , a t *1 (T e nn .Ct .A pp . A pr .2 6, 19 94 ) ( No Te nn . R. Ap p. P. 11 app lic a tio n f

ile d) ; Moser v . Bibee, No

. 0 3 A 0 1

- 9 2 0 9

- CV

- 0 0 3 4 7
, 1 9 9 3 WL 133292,

a t * 1 ( T e n n

. Ct

. A p p

. A p r

. 2 8
, 1 9 9 3 ) ( N o T e n n

. R. A p p

. P. 1 1 ap p li c a ti o n f il e d )

. We de c lin e to a

pp ly thi s a pp e a l- e nd ing pr e su mpt ion un le ss the re c or d a ff ir ma tiv e ly sh o ws that the trial court's de cision reg arding discretionary costs was ba sed on evidenc e other

than the parties' aff

idavits and the re cord a s a whole.

Mass. Mut. Life Ins. Co. , 104 S.W .3d at 36-37.19

Th e Cou rt fo un d th a t bec a us e the tr ia l cou rt ’s or de r de ny ing pla int if f’ s motio n for

dis c re tio na

ry c os ts did not aff

irmatively state t hat t he court hear d additional evidenc e re g arding discretionary costs at the hea ring , the Court did not need a tr anscr ipt of the hea ring in order to r eview the trial court’ s decision and the presumption that the evidenc e pre sented d u ri n g the hea ring supported the tria l court’s de cision was not applied. Mass. Mut. Life Ins. Co. , 104 S.W .3d at 37.

I n this case, the tr ial court’s or der state d:

This matter cam e b ef

o re the Court on November 4, 2004, for a

hearing on
mot ion s b y

bo th d e fe nd a nts fo r a n a wa rdof dis c re tio na

ry c os ts p ur su a nt t o T e nn . R. Civ. P . 54.04(2). Considering the motions, plainti ff’ s opposition t o the motions, and
t h e a rgu m en t s o f c o u n s e l a t t h e h ea ri n g, t o get h erwi t h al l t h e p ap er s an d p l ea d i n gs filed in this action, t h e C o u rt finds that the motions should be gr anted in part and de nie d in pa

rt . T he Cou rt

fi nd s that de fe nd a nt Dr

. Kl e pp e r is e nti tle d to re c e ive a ll the co st s he had re qu e ste d, e xce pt f or the $1 00 .0 0 c ha

rg e fo r the vid e ota

pe of his deposition. The Court f

inds tha t de fenda nt Pre mier Medica l G roup, P.C. is entit led
to rec eive a ll of the costs it h as re q u es t ed , except for the $100.00 c harg e for the videotape of

Dr. Kle pper’ s deposition, $4750.00 in preparation charg es fr om Dr. DeMa ria, a nd $4

, 8 0 0

. 00 in testimoni al cha rg es fr om Dr. De Maria r elating to the

m i s t r i a l i n J a n u ar y.

Si mi la r to th e tria l c o u r t’ s o r d e r e ntere d in Mass. Mut. Life Ins. Co. , th e or de r i n th is c a se failed to a ffirma tively

state that the trial court’s decision reg arding discretionary costs was based on evidenc e other

than Dr. K lepper

and Premier’ s motions, Carpe nter’s opposition to the motions, the arg uments of counsel, and the rec ord as a whole. There fore
, revie w of this issue is not precluded by the fa ilure to provide a transcript of t he hearing and we revie w the matter without the presumption that the evidenc e pre sented during the hea ring supported the tria l court’s de cision.

I t is Carp e nte r’ s con te nti on that the tr ia l c ou rt e rr e d in the a wa

rdof c e rt a in d isc re tio na

ry c os ts to Defe ndants bec ause D efe ndants failed to clear ly explain their ex pert witness fe es for Drs. Aa ron, Gelfa nd, and De Maria, and beca use De fenda nts failed to explain the basis f or transc ribing the trial
transcript. Carpente r does not a ppeal the awa

rd of discretionary costs associate d with any other c ourt rep o rt er ex pense. B oth Defe ndants attac hed an itemization of expenses to their motions for dis c re tio na

ry c os ts, ho we ve r, Dr . K le pp e r f a ile d to su mbi t a n a ff

ida vit of g ro un ds a s r e qu ir e d b y

Rul e 54.04(2). Dr . Klepper ’s attac hment to his mot ion provided:

COURT REPORTER FEES

DATE PAYEE AMOUNT DEPOSI TI ON

01/28/03 Vowell & J enning s $741.00 Tere sa Carpe nter 03/18/03 J ulianne M. Ve stal $182.00 Ba rbar a Seay20

03 /18 /03 Julia nn e M. Ve sta l $1 19 .0 0 Cin dy Tu bb e rv ill e 03/18/03 J ulianne M. Ve stal $143.50 Charles Miles 03/18/03 J ulianne M. Ve stal $ 87.50 Myra I shee 03/18/03 J ulianne M. Ve stal $112.00 Bittney Merc hant 03/18/03 J ulianne M. Ve stal $ 29.75 Ashley Carpente r 04/17/03 Christina Meza Rhode $ 74.74 Dr. Prea cher 04/30/03 J ulianne M. Ve stal $ 85.50 J oleen Moe 04/30/03 J ulianne M. Ve stal $ 99.75 Kar en Ke en 05 /06 /03 Ve rb a tim

Re po rt ing Se rv

. $ 7 8. 25 Ka thy Di tto 05/06/03 Ver

batim Reporting Ser v. $ 81.75 Dr. F .B. Pea se, Jr. 05/12/03 Vowell & J enning s $ 99.25 J essie R. Ba iley 06/03/03 VCE, I NC. $100.00 Dr. Timothy Klepper 06/12/03 Coastal Court Reporting $114.83 L y nne Mey er 07/21/03 Catherine Shay $243.00 Dr.Willi am Aar on 08 /08 /03 Julia nn e M. Ve sta l $1 60 .7 0 Jenn if e r H ine s & Dave Celeski 08/12/03 Ver

batim Reporting $138.50 Dr. Jeffre y C. W ilson 08 /25 /03 Vo we ll & Jenn ing s $ 8 8. 00 Ve rn on Carrig a n, MD 08 /25 /03 Vo we ll & Jenn ing s $2 07 .1 0 Rob e rt Mc Cor kle 08/25/03 Suncoast Reporting Serv. $167.10 Bonnie M. Fe rg uson 09/02/03 Alpha Reporting Corp. $ 53.00 Dr. M. Ge lfand 09 /04 /03 Coo k & Wile y , I nc $ 8 6. 25 Dr . E ri c De Ma ri a 10/22/03 Video South-Videog raphe r $375.00 Dr. M. Ge lfand 11/07/03 Vowell & J enning s $471.90 Dr. T. Kle pper 03/15/04 Marc i Hooten $218.50 Dr. M. Ge lfand 07/19/04 Vowell & J enning s $274.98 Dr. Jeffre y L arse n 07/23/04 Action Court Reporter s $158.00 J ohn Tarr 07/27/04 Br ag an Reporting Assoc. $ 95.32 J ulie Bur os

EXPERT WI TNESS FEES

10/20/03 Dr. M. Ge lfand $1500.00 09/23/04 Wil liam S. Aaron, M.D. $10,544.00

TOTAL : $16,930.48

In DePriest v . 171-19 W

est End Assoc.
, 9 5 1 S

. W

. 2 d 7 6 9
, 7 7 5 (T en n

. C t

. Ap p

. 1 9 9 7 ), t h i s Court

reve rsed the tr ial court’s awar d of di scre tionary costs provided byRule 54.04(2) of the Tenne ssee R u l es o f C ivil Proce dure to de fenda nts be cause of their failure to support the ir motion with a sufficie nt a ffidavit of g rounds. The de fenda nts’ motion merely stated, “O SR Defenda nts seek to tax dis c re tio na

ry c os ts p ur su a nt to Tul e 54 .0 4( 2) , T.R. C.P. Th e a mou nt o f tho se dis c re tio na ry c os ts i s21

$11,594.59, plus fees of A. Nea l Graha m, Plainti ffs’ e x pert witness.” De Pr ie st , 951 S.W .2d at 774. Finding the def

endants’ a ffidavit def

icient, the C ourt noted t hat the af fidavit supporting the motion stated onl y the t ie s pent and the c harg es there for. De Pr ie st , 9 51 S.W. 2d a t 77 4. Simi larl y , in thi s

case , Dr. Klepper failed to submit any aff idavit supporting his motion and the exhibit to his mot ion

mere ly listed the names of his ex perts, a date, and a n amount. We theref ore r ever se the trial c ourt’s

awa rd of e x pert witness fe es to Dr. Kle pper.

Whil e Premier

complied with the af

fidavit requir ement of Rule 54.04(2), neither the motion, the exhibit to the motion, nor the aff idavit pr ovided a sufficie nt e x planation of which of the many fe e s li ste d f

or Dr . D e Ma

ri a re pr e se nte d h is f

e e fo r atte nd in g t he tr ia l. P re mie r’ s a tta c he d e xhibi t provided:

EXHI BI T A

02/28/03 Depositions of Timothy Klepper and Te resa

Carpente r $ 749.60 02/28/03 Video De position of Timot hy Klepper 100.00 03/17/03 Ex pert fe e re tainer f or Eric DeMa

ria, M.D. 800.00 05 /09 /03 De po sit ion s o f M yra I sh e e , K are n K e e n, B ri tne y Me rc ha nt, B arb ara Se a y , Ch arl e s Mi le s, Jole e n M oe , Ci nd y Tu bb e rv ill e and Ashley

Carpente r 480.00 05/23/03 Deposition of B onnie Fe rg uson 167.10 05/23/05 Deposition of L y nne A. Me y er 114.00 06/27/03 Ex pert fe e for Clifford B lack, Jr., M.D. 875.00 08/04/03 Depositions for Jennifer Hine s and Da ve Celeski 160.70 08/12/03 Ex pert fe e for Dr. De Maria, M.D

. 4,800.00 10/31/03 Deposition of Michae l Gelfa nd, M.D. 64.75 01/07/04 Ex pert fe e for Eric De Maria 650.00 01/09/04 Deposition of B ob McCorkle 124.05 07/23/04 Deposition of J ohn Tarr 158.05 07/23/04 Deposition of J eff rey L arse n, M.D. 274.98 07/23/04 Deposition of J ulie Bur os 93.27 06/10/04 Ex pert fe e re tainer f or Eric DeMa

ria, M.D. 4,800.00 08/09/04 Ex pert fe e for Eric De Maria, M.D

. 4,690.96 08/15/04 Trial tra nscript 825.00

Total $19,927.46

The a ffidavit of Pre mier’s Counsel stated:

W. Sc ott Sims , h a vin g be e n d uly

sw or n a c c or din g to l a w, sta te s a s f oll ow s: 1. I a m a n a tto rn e y

lic e ns e d to pr a c tic e in T e nn e sse e . I a m cou ns e l of re c or d in this action for de fenda nt Premier Medic al Group, P.C. (“Pre mier”)

.22

2. An ite mize d li st o f P re mie r’ s d isc re tio na ry c os ts i n th is a c tio n is a tta c he d to Premier’ s motion seeking a n awa rd of those costs. All of the c osts included in that itemiz ation wer e nec essa ry for Premier’s def ense in this action and

we re re a so na

ble in a mou nt. 3. Al l th e c os ts i n Pr e mie r’ s it e miza tio n a re wi thi n the sc op e of

Te nn .R. Civ .P. 54.04(2) and are rec overa ble by Premier, ex cept for $4,750.00 in char g es for Dr. Er ic J . DeMa

ria, Premier ’s expert. Those c harg es re late to re view and pr e pa ratio n e ff orts b y Dr . D e Ma

ri a a nd sh ou ld be de du c te d f ro m th e tot a l in the itemization. 4. Premier did not eng ag e in any conduct in this action that justi fies depriving it of the discre tionary

costs it is seeking to r ecove r.

I n Mass. Mut. Life Ins. Co. , this Court ref used to a llow pla intiff to rec over its alleg ed expert witness fee s, finding that plaintiff failed to a dequate ly differ entiate betwee n the ex p er t fe e f or attending the trial and the expert fee for non- rec overa ble trial pre para tion services. The Court stated:

Dr. Ke nner te stified at trial. De spite the trial court’s opinion reg arding the value of his testimony , prese nting e x p ert e vidence reg arding [defendant’ s] m ental infirmities and their ef

fe ct on his abilityto prac tice psy cholog y was ne cessa

ry and

rea sonable. Howeve r, [pl aintiff] is not e ntitled to re cover any of Dr. K enner ’s fe es as discre tionary

costs for two r easons. F irst, much of his fee plainlyinvolved nonrec overa ble trial pre para tion services. S econd, the aff idavit supporting the motion
to as s es s d iscretionary

costs does not identify

which of D r. Ke nner’ s many fee s

re pr e se nte d h is f

e e fo r attendin g the tr ia l. A c c or din g ly , [pl a int if f] h a s f a ile d to de mon str a te that it is en tit le d to re imb ur se me nt f or a ny po rt ion of

Dr . K e nn e r’ s f

e e s.
Mass. Mut. Life Ins. Co. , 104 S.W .3d at 38-39.

Simi larly
, Premier’ s motion, attac hed exhibi t, and af fidavit failed to suff

iciently explain the five sepa rate entries f

or expert fe es re g arding the servic es of Dr . DeMa ri a. I t is well settled that “pre vailing pa

rties ca nnot rec over e x pert witness fee s for prepa ring for de positions or trial, no matter how rea sonable and nece ssary these fee s are .” Mass. Mut. Life Ins. Co. , 1 04 S.W. 3d a t 38 . B e c a us e Premier f ail ed t o d iffer entiate be tween D r. De Maria’ s rec overa ble and non- rec overa

ble expert witness fee s and beca

use we cannot pr esume that a dditional evidence prese nted during the hea ring

on No ve mbe r 4 , 2 00 4, c lari fie d s uc h a mbi g uit ie s, we fi nd that Pr e mie r i s n ot e nti tle d to reimburse ment for a ny

portion of Dr. D eMar ia’s fe es.

F ina lly , w e fi nd that Ca

rp e nter’ s c ha lle ng e of

the $8 25 .0 0 d isc re tio na

ry c os t a wa rd e d to Premier f or the pre para tion of the tri al transc ript is without m erit bec ause it is a re asonable and

nece ssary court re porter e x pense, c lear ly contemplated unde r Rule 54.04(2).

CONCL USI ON23

B e c a us e we fi nd that th e te sti mon y of ne ith e r Dr . A aro n n or Dr . D e Ma

ri a wa s a dmi ssi ble in

e vid e nc e un de r the sim ila r l oc a lit y ru le
, the j ud g me nt o f the tr ia l c ou rt is r e ve rs e d a nd the c a se

re ma nd e d f

or a ne w t ri a l on a ll i ssu e s.

Since no er

ror is asse rted a s to the verdict of the jury and the judg ment there on, except the

err or base d upon the similar locality rule, no other

rea son exi sts in the recor d for disturbing the judgme nt of the trial court as to liabilit y in this case

. For this re ason, we have a ddresse d other issues

ra ise d wh ic h a

re ri pe fo r d isp os iti on in the e ve nt w e are fo un d to be in e rr or a s to the sim ila

r l oc a lit y

ru le u n d e r th e r e c o r d in th is c a s e

. I t is f u r th e r ap p r o p r iate to s a y th a t if w e ar e c o rr e c t a s to the loc a lit y ru le
, the dis c us sio n of the oth e r iss ue s is re nd e re d moo t. Jud g me nt f or dis c re tio na

ry c os ts is r e ve rs e d w ith imp os iti on of dis c re tio na

ry c os ts t o a wa it t he ou tc ome of a ne w t ri a l.

Th e jud g me nt i n th e tr ia l c ou rt is r e ve rs e d a nd the c a se re ma nd e d fo r a ne w tr ia l on a ll i ssu e s. Cos ts o f the c a us e are a sse sse d to Ap pe lle e s.

___________________________________ W I L L I A M B

. C A I N
, J.